Shirley Benn (left) receiving her A & E Foundation Award from Dr. Chaynie Williams at the Accident and Emergency Department’s 20th anniversary dinner at the Hilton Barbados on Saturday night.

Take emergency care to community

8/30/2010

The future of emergency medicine in Barbadosis to take it into the community through the polyclinic system.

That is the view of the featured speaker Dr. Frank Bishop who worked in the Accident and Emergency (A&E) Department at the Queen Elizabeth Hospital (QEH) for 10 years.

“If we turn out emergency physicians every year, we need to find an outlet for them. The Emergency Room (ER) can only use so many of them. We therefore need to take the emergency room into the polyclinics. We need to look at what a polyclinic would need to start an emergency service-emergency trained staff, X-ray machine, EKG machine, point of care laboratory,” said Dr. Bishop.

“Apart from having the equipment, we need the trained personnel in the polyclinic system… Hopefully we can see a lot more patients outside of the hospital setting and they would not need to reach the A & E Department,” he continued.

He suggested that a corporate entity could sponsor a pilot such as this in the polyclinic to speed up the process since “we have the infrastructure in the polyclinics already.”

According to him such a move would be beneficial because Barbadians can be assured that they will get a certain level of emergency care that they know will be on par with what they get at the QEH and ease the pressure off the QEH as well.

“The future of emergency medicine is to take it out into the community. Let it be the first speciality to establish a permanent presence in the polyclinic system and provide that much need emergency service to the community,” he stated.

Dr. Bishop that a major problem in the A&E is a lack of space due to patients being unable to be admitted to the wards and suggested that a monitoring facility away from the emergency department be established where ill patients can be transferred to while awaiting admission.

“This would free up the beds in the ER and you could hold those patients whose blood results you are awaiting to determine whether they need admitting or not in that location as well. We would then have beds and rooms to see patients,” he said, but noted that staffing would be a problem due to shortages at this point of time.

According to him, another major complaint is the length of time it takes patients to be seen and suggested that the triage nurses should be permanently at the front to access the severity of the illness of a patient and that more people be trained in triage. He added that other problems interfering with the speed of discharging people from the A& E are getting results on time and doctors seeing patients in a timely manner.

He also said that the ER needs some assistance from service clubs and corporate Barbados. “There needs to be a concerted effort to assist the Emergency Department. The other service clubs and people assist the other departments in the hospital… We work probably under the worst conditions to provide the best possible care.”